经右胸并上腹两切口行食管癌根治术25例体会

从1989年9月～1994年9月，以右胸后外切口及上腹正中切口行食管癌根治术25例（“二切口”），与“三切口”及左胸单切口术式也各25例作对照进行分析．发现上述二切口术式有其一定的优越性．主要是暴露好．切除率高．胸腹淋巴清扫彻底；吻合可靠．并发症少。又从切口与切除率，淋巴结切除个数，切口与食管切除长度及切缘（＋），肿瘤是否易残留及切口与并发症、死亡率和食管癌有多区转移特点等方面作了初步讨论。根据资料提示认为胸部食管癌“二切口”根治方式具有不少优点。特点是对病期较晚、浸润较广有淋巴转移的病例选用本术式是适宜的，Ⅲ期病例各组根治性切除串“二切口”组91％，与两对照组的80％及60％有明显区别。而对较早期的食管下段癌可达用左胸单切口，较早期高位癌适于“三切口”．在行二切口术中发现上纵隔或胸顶有淋巴转移需全食管切除时也可转为颈部吻合，术后加颈部放射治疗。

Esophagectomy Performed by Right Thoracotomy Upper Abdominal Incision

From Septemler 1989 to septembe 1994, 25 cases of esophagectomies were Performed by right posterolateral thoracotomy and upper aboominal incision (two inciaions) for ford or Lower opion of esophageal carcinoma Comparing with "three incisions" or left postero-lateral thoracotomy, This method Shows:excellent expesure, High resectability (especially high radical reasetabillty). Thorough removal of re-quired lymph uedes. Reliable anastomosis, and less complications etc. Comparing with other entering method during the same peried, the au-thors think that two incision mehod is acceptable in esophagectomy for those bo bocated in mid or lower portion of asephagus.